Nursing diagnosis – DIARRHEA

DIARRHEA

DEFINITION

Passage of loose, unformed stools

DEFINING CHARACTERISTICS

• Abdominal pain and cramping

• At least three loose, liquid stools per day

• Hyperactive bowel sounds

• Urgency

RELATED FACTORS

• Psychological: anxiety, high stress levels

• Physiological: malabsorption, infectious processes, irritation, para-

sites, inflammation

• Situational: adverse effects of medications, alcohol abuse,

toxins, laxative abuse, contaminants, radiation, tube feedings,
travel

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Coping

• Fluid and electrolytes

• Emotional

• Nutrition

• Elimination

EXPECTED OUTCOMES

The patient will

• Have less or no diarrheal episodes.

• Resume usual bowel pattern.

• Maintain weight and fluid and electrolyte balance.

• Keep skin clean and free from irritation or ulcerations.

• Explain causative factors and preventive measures.

• Discuss relationship of stress and anxiety to episodes of diarrhea.

• State plans to use stress-reduction techniques (specify).

• Demonstrate ability to use at least one stress-reduction technique.

SUGGESTED NOC OUTCOMES

Bowel Continence; Hydration; Symptom Control

INTERVENTIONS AND RATIONALES

Determine: Monitor and record frequency and characteristics of

stools to monitor treatment effectiveness.

Identify stressors and help the patient solve problems to provide

more realistic approach to care.

Monitor perianal skin for irritation and ulceration; treat according

to established protocol to promote comfort, skin integrity, and free-

dom from infection.

Perform: Administer antidiarrheal medications, as ordered, to

improve body function, promote comfort, and balance body fluids,

salts, and acid–base levels. Monitor and report effectiveness of

medication.

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Provide replacement fluids and electrolytes as prescribed. Maintain

accurate records to ensure balanced fluid intake and output.

Inform: Teach patient to use relaxation techniques to reduce muscle

tension and nervousness; recognize and reduce intake of diarrhea-

producing foods or substances (such as dairy products and fruit) to

reduce residual waste matter and decrease intestinal irritation.

Instruct patient to record diarrheal episodes and report them to

staff to promote comfort and maintain effective patient–staff

communication.

Attend: Encourage patient to ventilate stresses and anxiety; release of

pent-up emotions can temporarily relieve emotional distress.

Encourage and assist patient to practice relaxation techniques to

reduce tension and promote self-knowledge and growth.

Spend at least 10 min with patient twice daily to discuss stress-

reducing techniques; this can help patient pinpoint specific fears.

Manage: Consult with dietician to determine foods that may be

related to diarrheal episodes.

SUGGESTED NIC INTERVENTIONS

Diarrhea Management; Nutrition Management; Skin Surveillance;

Weight Management

Reference

Fletcher, P. C., & Schneider, M. A. (2006, September–October). Is there any

food I can eat? Living with inflammatory bowel disease and/or irritable
bowel syndrome. Clinical Nurse Specialist, 20(5), 241–247.

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